Chronic non-cancer pain management – insights from Australian general practitioners: a qualitative descriptive study
Lucy Gilkes
A * , Caroline Bulsara A and Nahal Mavaddat B
A School of Medicine, The University of Notre Dame, PO Box 1225, Fremantle, WA 6959, Australia.
B School of Medicine, Division of General Practice, University of Western Australia, Crawley, WA, Australia.
Australian Journal of Primary Health 29(4) 365-374 https://doi.org/10.1071/PY22144
Submitted: 11 July 2022 Accepted: 12 December 2022 Published: 23 January 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: The study explored the experiences and perceptions of GPs regarding the management of chronic non-cancer pain (CNCP). Specifically, participants were asked to identify perceived enablers and barriers to CNCP care and how the care of patients with CNCP may be improved.
Methods: The study utilised a qualitative descriptive methodology. General practice in Western Australia. The sample was purposive with 12 Australian GPs from predominantly metropolitan locations and with experience in managing CNCP. Semi structured interviews were conducted. Each interview was of 45–60 min duration. All interviews were audio recorded and transcribed using a secure transcription service. Thematic analysis developed themes inductively and deductively.
Results: Themes emerged regarding: the importance of a holistic and personalised approach; the important role of a coordinating GP; the need for an evidence-based approach to opioid management; concerns relating to access to multidisciplinary services; the importance of clinician and patient education regarding CNCP; and an acknowledgement of the challenges for doctors and patients in managing CNCP.
Conclusions: Currently, the management of CNCP in Australia is challenging. Notable challenges include: difficulties with continuity of patient care; challenges with patient expectations of treatment, in particular opioid medications; difficulty with access to the health services required to enable holistic care; and the need for improved pain education in the community. The breadth of these challenges suggests there is a need for supportive organisational and structural considerations in the healthcare system to enable optimal care of CNCP in the community.
Keywords: holistic health, medication therapy management, patient care: management, patient care: team, primary health care.
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